| Outcomes | No. of Participants (studies) Follow up | Quality of the evidence (GRADE) | Relative effect (95% CI) | Anticipated absolute effects | |
|---|---|---|---|---|---|
| Risk with standard treatment/placebo - high risk – adults | Risk difference with TXA (95% CI) | ||||
| No. of patients needing blood transfusions | 4105 (38 studies) | VERY LOWa,b,c due to risk of bias, inconsistency, imprecision | RR 0.71 (0.63 to 0.81) | Study population | |
| 475 per 1000 | 138 fewer per 1000 (from 90 fewer to 176 fewer) | ||||
| No. of units of blood transfused -all patients | 1918 (16 studies) | LOWa,b due to risk of bias, inconsistency | The mean no. of units of blood transfused - all patients in the intervention groups was 0.83 lower (1.17 to 0.5 lower) | ||
| Mortality | 3771 (31 studies) | VERY LOWa,c,d due to risk of bias, inconsistency, imprecision | RR 0.52 (0.31 to 0.87) | Study population | |
| 19 per 1000 | 9 fewer per 1000 (from 2 fewer to 13 fewer) | ||||
| Length of hospital stay | 182 (3 studies) | MODERATEa due to risk of bias | The mean length of hospital stay in the intervention groups was 0.08 lower (0.35 lower to 0.18 higher) | ||
| Infections | 100 (1 study) | LOWa,c due to risk of bias, imprecision | RR 0.62 (0.31 to 1.24) | Study population | |
| 320 per 1000 | 122 fewer per 1000 (from 221 fewer to 77 more) | ||||
| Thrombotic complications | 986 (10 studies) | LOWa,c due to risk of bias, imprecision | RR 0.48 (0.18 to 1.23) | Study population | |
| 25 per 1000 | 13 fewer per 1000 (from 20 fewer to 6 more) | ||||
Majority of the evidence was at high risk of bias.
Downgraded by one increment due to heterogeneity, I2=72%.
Confidence interval crosses one MID.
Downgraded by one increment as the point estimate varies widely across studies, unexplained by subgroup analysis.
From: 6, Alternatives to blood transfusion for patients having surgery: Cell salvage and tranexamic acid
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